ENEchocardiography is an ultrasound scan of the heart: the same method used for the abdomen, aimed at an organ that never stops working. It needs no radiation, needs no preparation in its simple form and takes twenty to thirty minutes — and yet almost every decision a German cardiologist makes starts with it.
Below: what echocardiography in Germany shows, its variants and how they differ for the patient, what a German report contains and how to read it, why the study is repeated before valve surgery, and where it is done. A doctor explains what the numbers in your report mean. Heart conditions overall: heart treatment in Germany; other examinations: diagnostics in Germany.
What a heart ultrasound shows
A heart ultrasound shows the size of the chambers, the thickness of their walls and how they move, the state of the four valves, and any fluid in the sac around the heart.
The key number in the report is the ejection fraction: the share of blood the left ventricle, the main pumping chamber, ejects with each beat. It is not a «percentage of heart health»: a heart can be diseased with a normal ejection fraction, and some people feel reasonably well with a reduced one, so a German report never consists of a single figure.
Valves are judged by the speed of blood flow: in Doppler mode, ultrasound measures how fast blood crosses a valve, and from that speed doctors judge how narrowed it is and how much blood leaks back. These measurements answer whether it is time to operate; the operation itself is covered under aortic valve replacement in Germany. The current valvular heart disease guideline of the German Cardiac Society (DGK), available in German only, sets out how such measurements grade valve disease and time a procedure.
The variants, and what the patient experiences
There are three main variants, and each feels different. An ordinary echocardiogram uses a probe on the chest and needs nothing more than undressing to the waist and lying on one side; the method is that of any ultrasound in Germany. In a transoesophageal study the probe is swallowed, as in a gastroscopy: nothing is eaten that morning, the throat is numbed locally and, if needed, sedation makes the person drowsy. It is done when the view through the chest is poor, or when the valve and the atrium must be seen before an operation or a procedure for an arrhythmia.
Stress echocardiography is done under load: the person pedals an exercise bike or, if unable to, receives a drug that speeds up the heart, dobutamine. It shows what the heart lacks at work rather than at rest. 3D and contrast studies can be added: 3D gives volume, contrast shows the heart’s inner outlines better, and the doctor orders them for a specific question.
The German report, and why the study is often repeated
A German report is a page of measurements with figures and reference ranges, and clinics repeat the study to get figures of their own. Instead of a line saying «no pathology found», it gives sizes, thicknesses, velocities, areas and pressure estimates, with the conclusion in a separate block. Set beside the previous report, it shows the trend, so old protocols are worth bringing.
Even if an echocardiogram was done at home a month ago, a German clinic usually repeats it. The study depends heavily on who holds the probe: two operators can measure the same valve differently, and the decision to operate rests on measurements. This is not distrust of a colleague but a requirement of the figure a doctor signs before an intervention.
Where it is done and by whom
The study is performed by a cardiologist or a trained specialist under a cardiologist’s responsibility, and a doctor signs the report. The Department of Cardiology at Munich Hospital Harlaching is headed by Prof. Harald Kühl, whose work is on imaging of the heart by ultrasound, magnetic resonance and computed tomography. Cardiology at Munich Hospital Bogenhausen is headed by Dr Sebastian Rogowski, whose main fields include echocardiography with 3D imaging and non-invasive and invasive cardiac imaging, from outside or via a catheter. At the German Heart Center at Charité in Berlin, cardiology runs as three departments on different campuses. The Heart and Diabetes Center NRW in Bad Oeynhausen has a Department of General and Interventional Cardiology/Angiology and a Heart Failure Center. More addresses: cardiology hospitals in Germany.
When booking, ask which variant has been ordered and why, whether sedation and a companion are needed, whether you will receive the report with measurements and the video recording, and whether translation is included. For a transoesophageal study, ask when to stop eating and arrange who takes the patient home after sedation.
Frequently asked questions
Does echocardiography hurt?
An ordinary echocardiogram does not: the probe rests on the chest and you only feel its pressure. A transoesophageal study is less pleasant because the tube is swallowed, so the throat is numbed and sedation given if needed. Stress echocardiography feels like exertion.
How do I prepare for echocardiography?
An ordinary study needs no preparation: you undress to the waist and lie on one side. A transoesophageal study is done on an empty stomach, and after sedation a companion should take you home. Bring previous echo reports, ECGs and discharge letters for comparison.
What does the ejection fraction in an echo report mean?
It shows what share of blood the left ventricle ejects with each beat. It is an important number but not a verdict on the whole heart: a heart can be diseased with a normal ejection fraction. What it means for you, together with the other measurements, is explained by a doctor.
How AlenMed arranges the study
AlenMed starts with the documents: previous echo protocols, the ECG, discharge letters and images go to a German cardiology department, whose doctor says which variant your question needs, whether to repeat the study and what to add on the same day so that you do not travel twice. Then come a written estimate, the visa invitation, appointments in one block and an interpreter when the result is discussed.
Plan for the report with measurements and the recording in a format your doctor at home can open, a translation, and clarity on what happens if the study shows severe valve disease and the talk turns to surgery at once.
This material is for information only and is not an offer. Which study is needed and what follows from its result are decided by a doctor at an in-person examination.